Commercial Propane and Fuel Application

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Name of Business

Email
*

Billing Address
*

City

State

Zip

Service Address
*

City

State

Zip

Business Phone
*

*If you designate a primary telephone number for notifications on your account, you are hereby expressly agreeing that the Cooperative may deliver pre-recorded, artificial voice, and/or auto-dialed messages to this primary telephone number, whether the telephone number is for a landline, wireless, cellular telephone or texts.

Contact Person
*

Federal Tax ID
*

Business Type
*

Corporation

Partnership

Sole Proprietorship

Type of Business
*

Number of Years in Business
*

Do you have an existing tank?
*

Yes

No

Do you own an existing tank?
*

Yes

No

What type of fuel do you use?

Fuel Oil

K1 Kerosene

Propane

If propane, what size is your tank?

420 lb. cylinder

250 gallon tank

325 gallon tank

500 gallon tank

1000 gallon tank

Bank Reference

Bank Name

Address
*

City

State

Zip

Phone
*

Trade References

Company Name
*

Account#
*

Phone
*

Company Name
*

Account#
*

Phone
*

Company Name
*

Account#
*

Phone
*

Estimated Monthly Purchase
*

PREPAYMENT MAY BE REQUIRED IF YOUR ACCOUNT CANNOT BE ESTABLISHED THROUGH A CREDIT CHECK. A BLUE RIDGE ENERGY REPRESENTATIVE WILL CONTACT YOU IMMEDIATELY SHOULD THERE BE A QUESTION IN ESTABLISHING YOUR ACCOUNT.

BY SUBMITTING THIS FORM, I CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. BLUE RIDGE ENERGY, LLC IS AUTHORIZED TO MAKE ANY AND ALL INQUIRIES NECESSARY FOR ACTION ON THIS APPLICATION. I HEREBY INDEMNIFY BLUE RIDGE ENERGY, LLC AND ITS AGENTS FROM ANY LIABILITY RESULTING FROM THEIR CREDIT SURVEY.

I UNDERSTAND THAT BLUE RIDGE ENERGY, LLC TERMS ARE NET DUE - 30 DAYS AFTER DELIVERY OF PRODUCT AND AGREE TO MEET THESE TERMS IF CREDIT IS EXTENDED. BY SUBMITTING THIS FORM, I ALSO AGREE TO PAY ANY AND ALL FINANCE CHARGES, PENALTIES, OR COURT COSTS RESULTING FROM THIS ACCOUNT BEING DELINQUENT.

A FINANCE CHARGE OF 1.5% PER MONTH, WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% WILL BE ADDED ON THE REMAINING UNPAID BALANCE OVER 30 DAYS OLD.

LP Gas Agreement

The following terms and conditions apply:

EQUIPMENT: Company will install and maintain equipment at Customer’s property. The propane tank(s) and equipment listed below will remain property of Company and will not become part of the real property where it is installed.

MAINTENANCE: Company will have the right at all reasonable times to enter Customer’s property to install, repair, service, remove, move, disconnect, or inspect the tank(s) and equipment furnished by Company. Customer shall not attempt to install, repair, service, remove, move, disconnect, or in any manner tamper with any and all equipment provided by Company.

DELIVERY: Company will have the right at all reasonable times to enter Customer’s property to deliver propane. For reasons including but not limited to changes in customer usage, appliance changes in the home, system changes, actions of suppliers, Acts of God, and/or weather conditions, Company does not and cannot guarantee that Customer’s tank(s) will never run empty regardless of Customer delivery type (will call or autofill.) While Company will make every reasonable effort to deliver propane to Customer, Company will not be responsible for any damages resulting from tank being out of propane. Customer should periodically check the tank gauge percentage and notify company if level is low.

SAFETY: Customer agrees to operate equipment in a safe and lawful manner. Company will not be liable for any damages or injuries incurred due to negligence or misuse by Customer or any third party.

DAMAGES/SERVICE INTERRUPTION: Company is not liable for damages or injuries resulting from acts of God or any other circumstances beyond Company’s control including, but not limited to, flooding, hurricanes, tornados, lightning, wind, and heavy snow or ice. In the event of inclement weather, Company will make every effort to deliver to Customer; however, Company may suspend delivery if roads or weather conditions place employee(s) or property at risk.

SERVICEABILITY: Customer acknowledges that a safe driveway or delivery area is available. Company is not responsible for damages resulting from improper foundations or from normal wear and tear related to weather and/or age of driveway or entrance area. Customer further agrees to keep driveway clear and passable from debris, snow, ice, or other impairments. Delivery service may be suspended if driveway is not passable.

ASSIGNMENT: Customer agrees to notify Company in the event the property is sold. This agreement will terminate upon the sale of the property and cannot be assigned or assumed by the new property owner.

PAYMENT TERMS: Company agrees to provide propane service to Customer as long as Customer pays account in accordance with company terms. Payments are due in full within thirty (30) days of the invoice date for customers with approved credit. Finance charges will be assessed at a rate of 1.5% per month on any past due balance. Any and all other payment arrangements must be approved by Company. Customer shall be liable for all charges related to returned checks or bank drafts as provided in G.S. 6-21-3 and G.S. 25-3-506. Customer shall additionally be liable for reasonable attorney’s fees and court costs in the event debt collection is required. Company reserves the right to remove equipment, adjust or disconnect its equipment, and/ or suspend delivery upon Customer’s failure to comply with payment terms. Company agrees to notify Customer prior to removing equipment.

CANCELLATION: This agreement will remain in effect for one (1) year and continue thereafter unless terminated by either party by giving ten (10) days notice. If customer requests termination, Customer agrees to pay Company’s costs to remove its equipment (see Item 11 - TANK REMOVAL).

TANK LEASE/USAGE REQUIREMENT: Company has provided tank(s) for the purpose of delivering propane to Customer. A 100 gallon capacity tank will be assessed a tank rental (plus tax) that is billed annually regardless of propane gallons used annually. If minimal or no propane has been delivered within a twelve month period, Company reserves the right to implement fees and/or delivery or rental charges on tanks with a 200 gallon or greater tank capacity.

TANK REMOVAL: If tank(s) need to be removed for any reason including but not limited to non-payment or if Customer no longer uses propane, Company has the right to remove the tank(s) and any other Company owned equipment from the property. Customer agrees to pay Company’s costs to remove its equipment. Customer also agrees to pay a re-stocking fee per gallon of an amount set by Company if more than 5% remains in tank when it is removed from the property. These amounts would be deducted prior to Customer receiving reimbursement for any credit balance remaining on account. Note: for UNDERGROUND TANK(S) – In addition to Customer being responsible for the cost of tank removal, Customer will also be responsible for any and all reparations to the yard or landscaping.

PROGRAMS AND FEES: Company reserves the right to make changes, add, and/ or discontinue any and all existing programs, plans, services charges, or fees at its discretion without prior notice.

I have read and understand Blue Ridge Energy's LP Gas Agreement and Propane Safety Information above. Additionally, by checking this box, I understand that I am electronically signing and accepting the terms of the LP Gas Agreement.

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Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries. Google Play and the Google Play logo are trademarks of Google Inc.